title: Low-grade nonintestinal sinonasal adenocarcinoma: a diagnosis of exclusion.
abstract: The World Health Organization classifies primary sinonasal adenocarcinomas (SNACs) into salivary and nonsalivary types. Salivary types are usually well-defined myoepithelial neoplasms, which closely resemble their salivary counterparts. Nonsalivary types are separated into intestinal-type SNAC (ITAC) and non-ITAC, and both have low- and high-grade categories. Intestinal-type SNACs are aggressive tumors that resemble intestinal epithelium and often arise in the ethmoid sinus. Non-ITACs are of presumed seromucous gland origin, have marked morphologic heterogeneity, and can arise anywhere in the sinonasal tract. Moreover, ITACs typically demonstrate an intestinal-type immunohistochemical profile (CK20+, CK7-, CDX2+, and villin+), whereas non-ITACs reveal a respiratory-type profile (CK20-, CK7+, CDX2-, and villin-). Here, we present a case of low-grade, nonintestinal SNAC in a 17-year-old African American man and a discussion of the classification and pathologic features of primary SNACs.
authors.affiliation: University of Mississippi Medical Center, Jackson, MS 39216, USA. fbhaijee@umc.edu
authors.forename: Feriyl
authors.initials: F
authors.lastname: Bhaijee
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Carron
authors.forename: Diana
authors.initials: D
authors.lastname: Bell
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D000293:Adolescent; D018322:Angiofibroma / Q000175:diagnosis; D014408:Biomarkers, Tumor / Q000378:metabolism; D003937:Diagnosis, Differential; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D008297:Male; D009669:Nose Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor